OBJECTIVES: To study the relationship between skeletal muscle mass index (SMI) and metabolic phenotypes of obesity in adolescents, and to provide a basis for the prevention and control of adolescent obesity and related metabolic diseases. METHODS: A total of 1 352 adolescents aged 12 to 18 years were randomly selected by stratified cluster sampling in Yinchuan City from October 2017 to September 2020, and they were surveyed using questionnaires, physical measurements, body composition measurements, and laboratory tests. According to the diagnostic criteria for metabolic abnormalities and the definition of obesity based on the body mass index, the subjects were divided into four metabolic phenotypes: metabolically healthy normal weight, metabolically healthy obesity, metabolically unhealthy normal weight, and metabolically unhealthy obesity. The association between SMI and the metabolic phenotypes was analyzed using multivariate logistic regression. RESULTS: The SMI level in the metabolically unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity groups was lower than that in the metabolically healthy normal weight group (P<0.001). Multivariate logistic regression analysis showed that after adjusting for gender and age, a higher SMI level was a protective factors for adolescents to develop metabolic unhealthy normal weight, metabolically healthy obesity, and metabolically unhealthy obesity phenotypes (OR=0.74, 0.60, and 0.54, respectively; P<0.001). CONCLUSIONS Increasing SMI can reduce the risk of the development of metabolic unhealthy/obesity.
Adolescent ; Humans ; Body Mass Index ; Metabolic Syndrome/metabolism* ; Muscle, Skeletal/metabolism* ; Obesity, Metabolically Benign/diagnosis* ; Pediatric Obesity ; Phenotype ; Risk Factors ; Child

OBJECTIVEThe incidences of nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome (MS) are very high in obese children, and insulin resistance may be the key point linking them together. Debates still remain as to whether NAFLD could be a component of MS. Some researchers reported that NAFLD was a composition of MS, while the others stated that NAFLD was an independent predicting factor of MS. Here we analyzed the prevalence of NAFLD and MS in 308 obese children who came to our endocrinology department from June 2003 to September 2006, and we also evaluated the relationship between NAFLD and MS in this group of obese children.

METHODTotally 308 obese children aged from 9 to 14 years with mean age of (10.7 +/- 2.6) years were enrolled. Two hundred and thirty one were males, and 77 were females. Body mass index (BMI), waist circumference (WC), biochemical indicators, liver B-mode ultrasound examination, oral glucose tolerance test (OGTT) and insulin releasing test were performed for all of the cases. The incidences of NAFLD including simple nonalcoholic fatty liver (SNAFL) and nonalcoholic steatohepatitis (NASH) as well as MS were calculated. Three subgroups were selected according to the diagnostic criteria: Group 1: OCWLD (obese children without liver disorder), Group 2: SNAFL and Group 3: NASH. The prevalence of MS, components of MS, free insulin, whole body insulin sensitivity index (WBISI), homeostasis model of insulin resistance (HOMA(IR)) were compared among these three subgroups.

RESULT(1) Among all the obese children, the prevalence of NAFLD, SNAFL, NASH and MS was 65.9% (203), 45.5% (140), 20.5% (63) and 24.7% (76) respectively. Among all the MS children, the prevalence of NAFLD was 84.2% (64/76). The prevalence of MS was 29.3% (41/140) in SNAFL group and 36.5% (23/63) in NASH group, which was significantly higher than that of OCWLD group 11.4% (12/105) (P < 0.05), but no significant difference was found between SNAFL group and NASH group (P > 0.05). Moreover, there were significantly higher incidences in NASH group concerning every component of MS (hypertension, hyperlipidemia, hyperglycemia) compared with that of OCWLD group. The incidence of hypertension in SNAFL was significantly higher than that of OCWLD group. And the incidence of hyperlipidemia was markedly increased in NASH group compared with SNAFL group. NAFLD group had higher free insulin and more severe IR compared with that of OCWLD group. When OCWLD developed to SNAFL and NASH, free insulin and IR deteriorated calculated by HOMA-IR and WBISI. However there was no significant difference between NAFLD and MS children concerning free insulin and IR.

CONCLUSIONThe prevalence of NAFLD and MS hits high in obese children. The prevalence of NAFLD was very high among children with MS and NAFLD and MS shared the common mechanism of IR. The higher prevalence of MS and higher frequencies of MS components were tightly associated with the development of NAFLD and severity of IR.

Adolescent ; Child ; Fatty Liver ; diagnosis ; epidemiology ; etiology ; metabolism ; Female ; Humans ; Male ; Metabolic Syndrome ; diagnosis ; epidemiology ; Obesity ; complications ; epidemiology ; Prevalence

OBJECTIVETo analyze the relationship between body fat and beta-cell function in obesity women of Pi-deficiency with phlegm-dampness type (PDPD) and qi-stagnancy with phlegm-blocking type (QSPB).

METHODSSixty women, who had normal blood glucose level and without family history of diabetes, were enrolled. They were classified into non-obesity group and obesity group depending on their body mass index (BMI), and subjects of obesity group were differentiated into the PDPD type and QSPB type according to Chinese medicine syndrome differentiation. The body fat was detected using double energy X-ray absorptiometry, and the beta-cell function was assessed by measuring the acute insulin response (AIR), the under insulin curve area (AUCins), the under glucose curve area (AUCglu), and their ratio (AUCins/AUCglu), through intravenous glucose tolerance test (IVGTT).

RESULTSBMI, body fat and waist circumference (Wf) were higher in obesity subjects than those in non-obesity subjects, but showed no significant difference between the two obesity types. Comparisons between obesity women of different types showed that the fat content of trunk and total body, the ratio of trunk fat/total mass, AIR, AUCins, and AUCins/AUCglu were all higher in QSPB than those in PDPD. AIR, AUCins, AUCins/AUCglu showed good correlation with BMI, Wf, trunk fat and total body fat contents. Multiple linear regression analysis demonstrated the increasing of trunk fat content was an influencing factor of AIR.

CONCLUSIONObesity women of QSPB type possess higher body fat (especially the trunk fat) content and insulin resistance with high acute insulin response, so clinical intervention should dominantly pay attention to subjects with QSPB type of obesity.

Adipose Tissue ; Adult ; Body Mass Index ; Diagnosis, Differential ; Female ; Humans ; Insulin-Secreting Cells ; metabolism ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Obesity ; diagnosis ; metabolism ; Yang Deficiency ; diagnosis

PURPOSE: In recent years, obesity in children has become one of the major nutritional problems, and the trend is that number of obese children is increasing. The purpose of this research is to examine the incidence of obesity in pubescent school children in Seoul and Cheju, and to analyze body fat component, complications and eating habits of those obese children in order to obtain basic information for prevention of obesity in children in the future. METHODS: The total number of 4,555 junior high school students from 4 schools consisting of 1,234 boys and 3,321 girls were examined based on their height and weight. For those children, obesity index was calculated based on the 50th percentile obtained from standard weight for height of children proposed by the Korean Pediatric Association in 1985. The body fat component was measured and compared between 275 children of 530 obese children(11.6%) and 275 children from the control group by Futrex-5000 A body fat and fitness computer. Of those children, oral glucose tolerance test, blood pressure, and biochemical studies were performed on 31 children whose follow-up was possible, and their exercise load and eating habits were examined. RESULTS: It was found that 11.6% of the subject children were obese, which consisted of 12.4% in boys and 11.4% in girls. The study showed 11.4% obesity ratio in Seoul and 13.2% obesity ratio in Cheju, but the difference was insignificant. Percents of bodyfat was 25.3+/-5.7% (mean+/-SD) for control group, 32.9+/-4.8% for mild obesity group, 35.6% for moderate obesity group, and 37.2+/-4.0% for severe obesity group. The morbidity of complications of those 31 children whose follow-up was possible showed the highest percentage of 29.0% in hyperlipidemia, and lower percentage in hypertension, elevated AST and/or ALT, glucose intolerance, diabetes, respectively. The eating habit analysis showed the total calorie intake/total energy expenditure ratio of 1.10 which is higher in calories than energy consumption, and the food intake evaluation showed that 23.3% of fat was contained in total calorie intake. CONCLUSIONS: The childhood obesity becomes the primary cause of adult obesity, hypertension and diabetes, and therefore, eating habits and exercise load should be carefully observed in order to prevent childhood obesity. In addition to the health care provided currently by schools, regular physical check-up should undertaken for early diagnosis to conduct appropriate tests and treatment.
Adipose Tissue ; Adult ; Blood Pressure ; Child* ; Delivery of Health Care ; Early Diagnosis ; Eating ; Energy Metabolism ; Female ; Follow-Up Studies ; Glucose Intolerance ; Glucose Tolerance Test ; Humans ; Hyperlipidemias ; Hypertension ; Incidence* ; Jeju-do ; Obesity* ; Obesity, Morbid ; Pediatric Obesity ; Seoul

OBJECTIVES: The beta3 adrenergic receptor(beta3 -AR) may play an important role in the regulation of energy expenditure and lipolysis. A mutation of the beta3 - AR gene(Trp64Arg) has been reported to be associated with early onset of non-insulin dependent diabetes mellitus(NIDDM), obesity and syndrome X which are related with insulin resistance. It is well known that Korean NIDDM patients, in contrast to Caucasians, are mainly non-obese and have experienced severe weight loss during the course of disease. We studied the frequency of the mutation in Korean NIDDM patients and non-diabetics control and evaluated the clinical characteristics of Korean obese NIDDM patients. We investigated the frequency of the mutation in NIDDM patients and clinical characteristics of the patients with the mutation in order to elucidate the significance of the mutation in the pathogenesis of NIDDM in Koreans. METHODS: We studied 401 NIDDM patients and 99 controls. The NIDDM patients were divided into two groups, non-obese group and obese group, according to their body mass index at diagnosis of the disease. The Trp64Arg mutation was detected by the PCR/RFLP method using restriction enzyme Mva I. RESULTS: The Trp64Arg allele frequency(16M) of NIDDM did not differ from that(16%) of controls. Although the mutant allele frequency was not different between non-obese and obese group both in NIDDM patients and controls, the frequency of patient with the mutant allele was significantly higher in obese NIDDM patients than in non-obese NIDDM patients(38.5% vs. 26.9%, P=0.04). However, no significant differences were found in clinical and laboratory findings between the NIDDM patients with the mutant allele and those without the mutant allele. CONCLUSION: These data suggest that beta3 -AR mutation might be associated with Korean obese NIDDM, and other factors might also be associated with the development of obesity and insulin resistance in NIDDM patients.
Alleles ; Body Mass Index ; Diabetes Mellitus, Type 2* ; Diagnosis ; Energy Metabolism ; Gene Frequency ; Humans ; Insulin Resistance ; Lipolysis ; Obesity ; Receptors, Adrenergic* ; Weight Loss

No abstract available.
Citric Acid Cycle/physiology ; Cytochrome P-450 Enzyme System/metabolism ; Fatty Liver/diagnosis/pathology/ultrasonography ; Humans ; Obesity/*complications ; Severity of Illness Index

Herein, we report the case of a large benign insulinoma in an obese young man with a three-year history of asymptomatic hypoglycaemia. He presented to our outpatient department with a two-week history of dizziness and morning cold sweats. A random serum glucose test revealed hypoglycaemia. Upon admission, computed tomography and magnetic resonance imaging of the abdomen with intravenous contrast media showed an enhancing mass lesion in the uncinate process of the pancreas. To confirm the diagnosis, an intra-arterial calcium stimulation test with hepatic venous sampling was performed for preoperative localisation and to exclude the presence of occult insulinomas. The patient underwent an exploratory laparotomy, with successful resection of the pancreatic head tumour. Histology confirmed the diagnosis of insulinoma. The patient's postoperative recovery was uneventful, and he has not developed further episodes of hypoglycaemia three years post surgery.
Adult ; Blood Glucose ; analysis ; Calcium ; metabolism ; Contrast Media ; chemistry ; Hepatic Veins ; pathology ; Humans ; Insulinoma ; blood ; complications ; diagnosis ; Magnetic Resonance Imaging ; Male ; Obesity ; blood ; complications ; Pancreatic Neoplasms ; blood ; complications ; diagnosis ; Tomography, X-Ray Computed

PURPOSE: The traditional belief that obesity is protective against osteoporosis has been questioned. Recent epidemiologic studies show that body fat itself may be a risk factor for osteoporosis and bone fractures. Accumulating evidence suggests that metabolic syndrome and the individual components of metabolic syndrome such as hypertension, increased triglycerides, and reduced high-density lipoprotein cholesterol are also risk factors for low bone mineral density. Using a cross sectional study design, we evaluated the associations between obesity or metabolic syndrome and bone mineral density (BMD) or vertebral fracture. MATERIALS AND METHODS: A total of 907 postmenopausal healthy female subjects, aged 60-79 years, were recruited from woman hospitals in Seoul, South Korea. BMD, vetebral fracture, bone markers, and body composition including body weight, body mass index (BMI), percentage body fat, and waist circumference were measured. RESULTS: After adjusting for age, smoking status, alcohol consumption, total calcium intake, and total energy intake, waist circumference was negatively related to BMD of all sites (lumbar BMD p = 0.037, all sites of femur BMD p < 0.001) whereas body weight was still positively related to BMD of all sites (p < 0.001). Percentage body fat and waist circumference were much higher in the fracture group than the non-fracture group (p = 0.0383, 0.082 respectively). Serum glucose levels were postively correlated to lumbar BMD (p = 0.016), femoral neck BMD (p = 0.0335), and femoral trochanter BMD (p = 0.0082). Serum high density lipoprotein cholesterol (HDLC) was positively related to femoral trochanter BMD (p = 0.0366) and was lower in the control group than the fracture group (p = 0.011). CONCLUSION: In contrast to the effect favorable body weight on bone mineral density, high percentage body fat and waist circumference are related to low BMD and a vertebral fracture. Some components of metabolic syndrome were related to BMD and a vertebral fracture.
Aged ; Blood Glucose/metabolism ; Body Composition ; Body Mass Index ; Body Weight ; *Bone Density ; Female ; Humans ; Middle Aged ; Obesity/*complications/diagnosis ; Overweight ; *Postmenopause ; Republic of Korea ; Risk Factors ; Spinal Fractures/*complications/diagnosis

Fatty liver is caused by derangement of fat metabolism and can be reversed by removal of contributing factors. The contributing factors of fatty liver is known to be overweight, chronic alcoholism, diabetes mellitus, malnutrition, and drug abuse such as tetracycline. This study was carried out on 1335 persons who visited 'Soon Chun Hyang Human Dock Center' from March to June 1990. In analysis of the data, prevalence of fatty liver diagnosed by ultrasonogram by age and sex, laboratory finding between fatty liver group and normal group, and odds ratio of known contributing factors, were compared. The results obtained are as following; 1) The prevalence rate of fatty liver diagnosed by ultrasonogram is 29.6% in male and 11.5% in female. 2) Age groups with high prevalences are 40~50's in male (32.0%) and 50's in female (24.5%). 3) The fatty liver shows significant association with style (p<0.05), whereas not with hepatitis B-virus surface antigen (p>0.05). 4) All laboratory values except alkaline phosphatase and bilirubin are elevated significantly in accordance with the degree of fatty liver (p<0.01). 5) Fatty liver diagnosed by ultrasonogram showed so strong associations with body index, triglycerides and gamma-glutamyl transferase for males, and body index and fasting blood sugar for females that these factors may be used as supplementary data in establishing diagnosis of fatty liver. 6) Odds ratio of contributing factors are as follows; If the odds ratio of below 29 year of age is 1.0 then that of 30~39 is 1.74 (p=0.33), 40~49 is 2.47 (p=0.10), 50~59 is 2.86 (p=0.0570), over 60 is 1.81 (p=0.34). If the odds ratio of female is 1.0 then that of male is 5.67 (p<0.01). If the odds ratio of body index below zero is 1.0 then that of 0~9 is 5.08 (p<0.01), 10~19 is 12.37 (p<0.01), 20~29 is 29.19 (p<0.01), 30 above is 154.02 (p<0.01). If the odds ratio of below 99 mg/dl FBS is 1.0 then that of 100~120 is 106 (p=0.76), over 120 is 1.91 (p=0.02). If the odds ratio of below 29 micron/1 gamma-GT is 1.0 then that of 30~s59 is 2.11 (p<0.01), 60~90 is 1.87 (p<0.05), 90 above is 1.69 (p=0.15). If the odds ratio of below 149 mg/dl TG is 1.0 then 150~199 is 1.49 (p=0.05), 200~250 is 1.09 (p=0.77), 250 above is 2.53 (p<0.01). In summary, early diagnosis of fatty liver could be made by ultrasonogram supplemented with body index and serum triglyceride. The fatty liver could be preventive by avoiding contributing factors such as obesity, alcohol intake, high blood sugar appropriately.
Alcoholism ; Alkaline Phosphatase ; Antigens, Surface ; Bilirubin ; Blood Glucose ; Cross-Sectional Studies* ; Diabetes Mellitus ; Diagnosis ; Early Diagnosis ; Fasting ; Fatty Liver* ; Female ; Hepatitis ; Humans ; Male ; Malnutrition ; Metabolism ; Obesity ; Odds Ratio ; Overweight ; Prevalence* ; Substance-Related Disorders ; Tetracycline ; Transferases ; Triglycerides ; Ultrasonography*

OBJECTIVEDiscussion on utility and purposed value of obesity and abdomen obesity when body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) used as indexes predicting hypertension, hyper-blood glucose, and both clusters, to provide scientific basis for the decision on the indexes and their cut-off points of obesity and abdomen obesity in Chinese people.

METHODSUsing the data of diabetes mellitus (DM) from epidemiological studies carried out in 11 provinces/autonomous regions/municipalities of China from July 1995 to June 1997. Partial relative analysis, logistic multi-factors regression analysis, interaction analysis were used. Relative risk (RR), attributable risk proportion (ARP) and population attributable risk proportion (PARP) of hypertension, hyper-blood glucose, and the both cluster as BMI, WC, WHR with the different cut off points were analysed.

RESULTS1) The correlations between BMI, WC and blood pressure, blood glucose were better than the WHR. 2) After adjusted by age, sex, occupation leisure physical activity, education degree and the family history of DM, the results suggested that BMI, WC, WHR were important predictive factors, with relative importance as BMI > WC > WHR. 3) There were augment interactions on BMI, WC and WHR with hypertension, hyper-blood glucose, with the interaction of BMI and WC in particular. Their pure attributable interaction proportion were from 5.95% to 29.34%. 4) The values of RR were about 2.5 when BMI >/= 23, >/= 24 and >/= 25, suggesting the relationship with exposure factors and diseases were with medium and high maleficent extent. Their ARP were from 0.580 to 0.623 with PARP from 0.259 to 0.425. The values of RR were from 2.06 to 3.08 as WC >/= 85 cm in males, WC >/= 80 cm in females while WC >/= 90 cm in males, WC >/= 80 cm in females, which suggested that the relationship with exposure factors and diseases were in medium and high maleficent extent. Their ARP were from 0.515 to 0.676 while PARP from 0.241 to 0.431.

CONCLUSIONSSince the maleficent extent of exposure factors to diseases, the acceptability for overweight and obesity in population, and the prevention and care for overweight and obesity were just in the introduction stage in China. The utility value of predicted hypertension, hyper-blood glucose in BMI and WC seemed to be better then in WHR. We suggested that BMI used as the obesity index, with the diagnostic cut-off point BMI >/= 24. WC as the abdomen obesity index. The diagnostic cut-off points are suggested to be WC >/= 85 cm in males, and WC >/= 80 cm in females.

Adult ; Aged ; Blood Glucose ; metabolism ; Blood Pressure ; physiology ; Body Constitution ; Body Mass Index ; Diastole ; Female ; Humans ; Hyperglycemia ; diagnosis ; physiopathology ; Hypertension ; diagnosis ; physiopathology ; Logistic Models ; Male ; Middle Aged ; Obesity ; physiopathology ; Predictive Value of Tests ; Systole